Behind the Scenes: The Justifications for Opioid Maintenance Treatment in Finland

Abstract

Opioid maintenance treatment (OMT) has been developed within drug dependency treatment in Finland over the last 20 years. This study, based on interviews with 15 stakeholders and content analysis of 174 newspaper texts, draws on Boltanski and Thévenot's theory of justification to explore ways in which OMT has been justified and identifies the main actors contributing to its development. Multiple factors, involving different actors, have influenced the development process, reflecting the ethos of contemporary Finnish welfare and health policy. Currently, the main justifications for choosing OMT treatment seem to emerge from a neoliberal frame of understanding.

Keywords :

• opioid maintenance treatment (OMT)
• stakeholders
• justification theory

THE AUTHORS

Riikka Perälä, Ph.D., is sociologist and post-doctoral researcher at the Department of Social Research at the University of Helsinki. She specializes in ethnographic research methodology and is affiliated with the University of Helsinki Centre for Research in Addiction, Control and Governance (CEACG). Her research interests include: the transformation of the Nordic welfare states, the governance of social problems in the post-welfare era, and the position of marginalized population groups in the system of social and health care. She has studied these questions in the context of drug policy and substance user treatment.

Matilda Hellman, Ph.D., is docent (adjunct professor) –sociology, media and communication –and researcher and research coordinator at the Faculty of Social Sciences (sociology). She is affiliated with the University of Helsinki Centre for Research in Addiction, Control and Governance (CEACG). Her research interests comprise primarily: cultural and social aspects (perceptions definitions, images) of drinking, drug taking, and different addictive behaviors, as well as policy strategies to tackle lifestyle problems.

Anna Leppo, Ph.D., is sociologist and post-doctoral researcher at the Department of Social Research at the University of Helsinki. She has used ethnography and other qualitative methods to study professional and societal interventions in prenatal drug and alcohol use and pregnant drug users’ risk perceptions. Her current research interests include service users’ and providers’ experiences of and agency in opioid maintenance treatment and the effects of marketization on the welfare state and its service provision.

Notes

2 The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

3 The Finnish mark was replaced by the Euro in 1991; the amount noted would be equivalent to $1,959,468 currently.